Specific Phobia


A Phobia is a persistent, strong, irrational fear of a specific object or situation. The mere sight or mention of the entity can cause a panic attack reaction in the sufferer. As a result the object of phobia is avoided entirely. For example, an individual that suffers from a phobia of dogs may avoid any number of activities in order to avoid any contact with a dog including sidewalks, parks, cafes, etc. Phobias of commonly found things (such as dogs) can therefore become very debilitating. Individuals who suffer from phobia typically don’t present for treatment unless the phobia is getting in the way of their functioning and everyday lives. Common phobias include the following:

  • Agoraphobia: fear of open spaces (or anywhere outside of the home)
  • Mysophobia: fear of being contaminated by germs
  • Hemophobia: fear of blood
  • Arachnophobia: fear of spiders
  • Acrophobia: fear of heights
  • Aviophobia: fear of flying
  • Claustrophobia: fear of enclosed spaces
  • Ophidiophobia: fear of snakes
  • Thanatophobia: fear of death
  • Aquaphobia: fear of being immersed in water

Here is a list of less common phobias:

  • Hylophobia: fear of forests
  • Batrachophobia: fear of frogs
  • Erotophobia: fear of love
  • Noctophobia: fear of night
  • Gerontophobia: fear of old people
  • Somniphobia: fear of sleep

Specific Phobias often develop as a result of a traumatic incident involving an object or situation. Extreme fear becomes associated with the object. Due to this association, if the object is encountered later on, terror will follow. Let us take the example of fear of water (Aquaphobia). An extreme fear response occurs every time the individual is immersed in water. The individual could have developed this phobia because they have been attacked in the water, or perhaps have had a near drowning experience.

Trauma could also be vicarious, meaning a person can develop Aquaphobia because their mother experienced a traumatic event in the water and then told them about it, or they heard about a terrifying experience in the water. Some people are particularly sensitive and can develop a phobia simply by watching a movie like Jaws, or reading a book at an impressionable time.

Best Phobia Treatments

Systematic Desensitization

Specific Phobias are best treated with a method called Systematic Desensitization using “in vivo” exposure to the the feared object. This entails the phobia sufferer being exposed very gradually and slowly (in the safety of the therapeutic setting) to the feared object/situation until the exposure is in real life, and not just a mental image or picture of the object. The patient is instructed to create a “fear hierarchy” from least to most frightening exposures. An example of a fear hierarchy for spiders can look like this:

  • Reading the word “spider”.
  • Imagining a spider.
  • Looking at a picture of a spider.
  • Looking at a video of a spider crawling for 5 seconds.
  • Looking at a video of a spider crawling for 15 seconds.
  • Looking at a spider in a jar.
  • Looking at a spider crawl on the table.
  • Letting a spider crawl onto the hand.

This process might take a few months, is typically done in brief behavioral therapy and is mostly successful with phobias. By the end of the treatment the individual has become literally “desensitized” to the feared object. Certain phobias however, such as Noctophobia (fear of night time), are better treated with combination approach including exposure (described above), Psychodynamic (with a focus on family dynamics in the past), and treatment specific for trauma (such as EMDR).

EMDR

A trauma treatment such as EMDR (Eye Movement Desensitization and Reprocessing) might be most useful for certain phobias that do not lend themselves to Systematic Desensitization either because they have not been successfully treated with it in the past or because the object/situation cannot be reproduced by the therapist in the office. It is also true that some phobias are more a result of PTSD than anything else, and should be treated as PTSD would be. Once the trauma is successfully processed, the phobia should also be be made much less intense.